What We Get Wrong About Dying
nautil.us
nautil.us
This is one of the major problems in hospitals — when a family conspires with the doctor to keep from grandmother the knowledge that she is dying. Grandmother suspects that she is dying but probably doesn’t really want to know for sure and her family talk with her in such a way as to say, 'Well you’re probably be getting alright in a few weeks' — because they have this funny feeling that it’s important to build up courage and hope. And so they become liars and the mutual mistrust develops. So the person is left to die alone, suddenly, unprepared, and doped up to the point where death hardly happens. And there is no derivation from it of the peculiar spiritual experience that can come with death."
– Alan Watts
Not nearly enough, or we'd do more about it on a systematic basic. It's an abstract kind of professing of it being terrible (leaving aside people who don't even manage to do that much), without any of the concrete action that could take place if it was actually treated as a horrific tragedy on a species-wide scale.
I doubt humans as a whole will ever feel strongly that death is a negative force. However, improving quality of life is one of the easiest pitches to make, and doesn't necessarily disproportionally value the rich. In fact, the least worthwhile place to spend improving the quality of life would be people with enough money to dictate it already.
But hey—the idea of living for centuries is cool, I always wanted to be an elf.
I'd say it's fundamental, and on the short-term, we all understand that as a civilization. That's why every society protects its member from threats, including crime, fire, natural disasters, famine, war. It's not just about quality - you may live the happiest of lives, up until the point a bullet enters your brain[0].
I think there are three main moral reasons for fighting death:
- suffering in the process of death itself
- existential suffering of knowing your time is limited, and that of knowing you're about to die
- suffering of those who you leave behind
Efforts against #1 connect to quality of life, and with progress on that field, it could be resolved. #2 and #3 won't go away until we achieve (effective) immortality, and for many (myself included) they are the reason to support life extension. But maybe you're right, that a stronger pitch along #1 would help gather extra support.
Then there are economic debates about whether our societies could survive sudden doubling of expected lifespans, or whether we'll be able to offload people fast enough to off-world colonies. I say, we'll figure it out as we go along - it's a nice problem to have, as opposed to death.
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[0] - probably one of the most humane ways to die; one can hardly leave this world without suffering during the process of departure.
In my experience, this is largely limited to the young and sheltered. Mature people can proces death in healthy ways.
People stop dying. We stop losing a hundred and fifty thousand people forever every single day. The vast majority of resources that would go to health-related (and death-related) industries briefly get redirected to getting the cure to everyone, then get freed up for numerous other things. The state of science and human knowledge improves because we no longer lose experienced minds to age and infirmity. People start checking things off their "bucket lists", and adding many more to their life goals, realizing that they have all the time in the universe now. People stop having to mourn the losses of those they love. (There'd likely be more than a few points where people have to stop and re-mourn past deaths, once it truly hits them that death could have been eliminated much sooner.)
I would also recommend reading https://nickbostrom.com/fable/dragon.html .
> How would people vie for this immortality treatement?
Hundreds of organizations and tens of thousands of people would dedicate everything they have to getting the treatment to everyone as quickly as possible, asking only for what resources that people can afford, and using all of those resources to accelerate reaching more people before it's too late.
> For food?
We have more than enough food for everyone. If you're attempting to imply overpopulation, that's been studied, and it's not an issue.
If people somehow magically stopped dying of old age tomorrow, would we choose to solve the resource problems that caused by re-implementing anything similar to death as it exists now? Say, for example, by executing everyone at the age of 75?
I think we'd be much more likely to prefer an alternative solution, such as restricting birth rates.
> I doubt humans as a whole will ever feel strongly that death is a negative force.
We (correctly) consider death a strongly negative force in every single situation that we don't consider it inevitable. The only thing special about "inevitable" death at the end of a typical modern day lifespan is that we can't do anything about it. This is suggestive, to put it mildly.
Is it inevitable? No. Is it worth “fighting”? Definitely not! What a waste of money. Get back to me when there is any path forward on this that doesn’t lead to increased social and economic stratification so rich people can live longer.
Death is useful to fear in that we make better decisions. It’s not useful to fear in that conquering it will not improve your life.
Btw the “death is good” philosophy you mock is just epicureanism.
And one day it will not be, and we'll be sad that it once was and so many people were lost forever as a result.
> Get back to me when there is any path forward on this that doesn’t lead to increased social and economic stratification so rich people can live longer.
You are assuming a great deal that is not in evidence. It's ridiculously hard to raise funds to cure aging and age-related degeneration. Demonstrate that a cure exists, and it'll be easy to raise funds to get that cure to everyone and make it more efficient to administer and distribute. The gap from "exists" to "universally available" will not last long.
> It’s not useful to fear in that conquering it will not improve your life.
On a scale from zero to non-zero, where death is zero, conquering it necessarily improves your life, by preserving it rather than allowing its senseless cessation.
My father died 8 years ago and I remember that we all knew he had just a few weeks left in him. We didn't tell him and no doctor did either. He was still talking about how he can't wait to go fishing once he gets out of there. I think it was something nice to keep him from diving down in panic attacks and depression as I imagine I would knowing that my situation is that bad.
I'm not so brave and I don't know if I would like someone to tell if I'm about to die soon...maybe I would; this is hard to discuss from outside.
I was talking about the long wait many have to go through from finding out...to their final breath. From denial to acceptance might be a long road that scares me and I'm not sure if every bit of information can be beneficial or detrimental.
That feeling is totally unique, of being there on the edge of life where everything is so simple, and where nothing else matters, or nothing else seems to matter very much. From talking to people and hearing stories, I suppose most people think of family when they're close to death. I didn't so much think about family as much as I had kind of very simple and straightforward "aw-shucks" moments of regret about not doing the things I wanted to do in life before I got into those situations where thought I would be killed. Incidentally, after my tours, I traveled a lot in order to settle those regrets and ended up meeting a woman that became my wife. I also created some very deep and meaningful friendships. I'm kind of getting off track here, but my original point was that what you've said is true, but at least for my part, "the long wait" is only happening after the fact. Navigating through the civilian world has been a really tough experience after all that, specifically those times where I thought surely I was a dead man. That was something I didn't expect, "the long wait" coming after everything else.
If I was in that position, I would not want to know. I'd want to think about getting better, and I'd want to appreciate the time I had with my friends and loved ones without an omnipresent feeling of impending demise.
This is the issue that has been described in the topmost comment, isn't it? Talking about ones own ongoing dieing process might be the hardest thing to ever do but by not talking about it a person is set to die alone. We can make assumptions about how a particular person feels about that and whether it benefits them (or us) but it is very unlikely the person is entirely oblivious to what's going on. There is going to be despair and sleepless nights and we could help with that.
How could this be the one thing on earth that talking intimately about doesn't provide comfort?
By the way I am a fucking coward and this is mostly me thinking out loud.
Let's see if I can explain myself: I was diagnosed with leukaemia three years ago and now I'm on the last weeks of the treatment, for the moment (and waiting for the last bone marrow tests), it looks like the treatment has worked (although there's a decent chance of cancer coming back in the next few years).
Speaking for myself, one of the things that frustrates me is the reluctance from doctors to give a straight answer. I had to ask several times to get a decent idea of the worst case scenario[0]. For me, having a clear vision helped me frame all the other possible scenarios, from the best possible "cancer is gone forever" to the more probable "treatment will work but in 10-15 years I'll develop another cancer" as well as lining up the available treatments[1].
I don't consider myself specially brave, but I prefer to know the truth, no matter how painful it is. Most of the cancer patients I know think along the same lines (some really brave people there). I accept that some people might not handle the situation well[2], but based on my limited observations, there may be less than you seem to think.
To finish this, I don't know about your father's situation (I'm sorry for your loss, btw) and I might be completely wrong on this (and I apologize if this offends you, it's definitely not my intention), but I'd consider the idea that your father knew and that at least part of his talk about going fishing was his way of trying to cheer you up and protecting you. I know I've done that with my own family.
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[0] The question was "Assuming the treatment doesn't work, what can I expect?". The most direct answer I got (after all the evasives) was "It will be painless", which is code for "We will pump you full of morphine".
[1] If the leukaemia is not completely gone or it returns I still have the option of a bone marrow transplant (although it will probably destroy my liver and will need a liver transplant too), I could also go for immunotherapy, which has shown very good results with my type of leukaemia but, as far as I know, only one hospital in Europe has the equipment necessary to do it. Worst case... well, we'll see, but even then I have 2-3 options that don't involve being a husk full of morphine until the lack of oxygen in blood kills me.
[2] And that's why there's a team of psychologists with specific oncology training in my hospital, as well as religious support for the people that want it.
I gave it an extra thought and, for me, it may also be the system that's at fault. When he died they (the hospital) made me gather at least 5 liters of blood donated (friends, family etc) otherwise they won't help him. I also had to buy even the syringes and other super-basic stuff because "they were out". I probably lost my trust in the medical system we have here and I'm simply horrified at the idea of having to rely on it.
Do you mind if I ask what country was this in? It might be because I'm specially sensitive, but any system that allows that to happen to terminal patients and their families is definitely broken.
My father had cancer in his late 60s. He wasn't expected to live. He did live about 2 more decades. But following his surgery, he spent considerable time in ICU.
At the same time, another elderly patient spent the last two weeks of their life there in ICU. They repeatedly coded and had massive intervention. Doctors routinely did things like drain a gallon of fluid from the lungs, restart their heart, etc.
My mother was pretty disgusted. She felt the family knew this woman was never going home again and these torturous treatments were not extending life. They were merely dragging out her death horrifically because the relatives were not yet ready to accept it.
In many cases, this is the better answer:
...they tell us that attempting resuscitative efforts that are likely to be futile is not consistent with their values. In these situations, rather than asking for intubation and chest compressions, parents just want to hold their child and find meaning in those final moments of contact.
After a day of treatment, he knew it was all downhill from there. Doctors said further treatment would likely make him recover from the pneumonia, but that could take months, and scar tissue from the pneumonia would reduce his lung capacity further. Even before the pneumonia he was reliant on oxygen supply at home just to sit in a chair.
So in the early hours of the second day, he requested they turn off the oxygen supply. A doctor got called in to ensure he knew what the consequences could be, which he did, and then they turned off the oxygen.
He passed away peacefully a few hours later.
Painful as it was to lose him, I'm so glad they respected his decision.
(nothing judgemental in this comment, I'm genuinely curious)
In Norway. The cancer he had did not respond to chemo, and radiation therapy was out since it was small clusters spread all over the lungs. So there was really not much they could do.
To be fair, I was a bit surprised myself, but as I said I really appreciate that he got the chance to make his own choice in the matter.
In fact, preforming medical treatment against someone's expressed will is assult or battery and could land the doctor in prison.
I think you're confusing voluntarily withdrawing of life sustaining treatment with physician assisted suicide, they are nowhere near the same thing.
[1] http://www.zocalopublicsquare.org/2011/11/30/how-doctors-die...
Worth reading for this line alone. Beautiful.
Those are interesting pieces, as whether you fully agree with them or not, they are generally well thought out, as the author can and has put quite a lot of time into thinking about the subject.
https://www.livescience.com/59261-alzheimers-deaths-increase...
Many of us on HN are in professions where we are able to save enough money to live without being productive after the age of 65.
But also many of the people reading this will be 50 years old and have the option to purchase a second (vacation home), or a boat, or a fancy sports car, OR completely secure their retirement. Many of us will choose one of these luxury items and hope everything works out rather than saving for a retirement that could last into our 90's.
It’s a balance.
Money, Age, Enjoyment. Most can choose two, some can choose all, and some can choose none.
I wish we treated the elimination of aging and age-related degeneration the way we do traveling to the Moon, or Mars.
There are many avenues of research to achieve radical life extension, and it's a worthy thing to pursue.
For another keen perspective on how doctors deal with terminal illness in personal life, as humans, rather than as professionals, see this: http://www.saturdayeveningpost.com/2013/03/06/in-the-magazin...
Who decides people living now are more worthy of living than future generations?
Who decides who will live forever?
The problem I have with your sentences is that they prove too much. They can easily be read, for instance, as advocating that it might be worth abandoning medical science.
2. Everyone we can save.
That's not an either-or, it's a false dichotomy.
> Who decides who will live forever?
Once we have the technology, who is going to try murdering people by trying to make them not live forever?
The very obvious answer for "who should live forever" is everyone.
I think flying directly in the face of that argument was the point. There's a third alternative: don't shy away from it, don't "come to terms" with it, fight it with every fiber of your being.
Also, what about people that don't want to come back? Those that are content with their lot, or have religious beliefs that something like this would be in violation of? Should we go against people's beliefs because we think it's better for them?
If not, this seems like a personal decision for each person, and a complaint such as yours seems to be missing the forest for the trees.
Do you have any idea what the costs are, and how they compare to the rent-cost of the land occupied by cemeteries? I'm assuming these frozen heads could be stored with less pomp and decorum than dead bodies are today, so could be housed in multistory buildings.
>>Also, what about people that don't want to come back?
Couldn't people decide beforehand whether their brains are cryogenically preserved in the event of clinical death?
>>If not, this seems like a personal decision for each person, and a complaint such as yours seems to be missing the forest for the trees.
I don't think the parent comment is suggesting making this mandatory or done without explicit consent. Only that we would have benefited from having a cultural shift which makes this the primary response to death.
How about the one time fee for cremation?
> I don't think the parent comment is suggesting making this mandatory or done without explicit consent.
I admit that I was interpreting it along those lines originally. I'm not sure if that was my mistake based on local context or if it was edited afterwards to clarify their intended point.
I do still believe it's a bit naive to think we can assume the ability to rectify the problem of a frozen brain in a jar within the semi-near future, or even that we are preserving them correctly, but I'm all for giving people the choice as long as we ruthlessly weed out those who present their services as scientifically sound when they aren't (if they present it as mumbo jumbo, then whatever).
I've been pondering that and I don't think it would be much if you did a cheap and cheerful version. The cryonics institute charge about $30k/person for indefinite storage for whole body and only do about 4 a year. Chop the heads off and put them in a large refrigerated building and you could probably get it to a fraction of that. I figure you could get about 5 million in a WalMart sized building.
In the US lifetime healthcare costs were $316k in 2004. So now maybe 400k. Why spend 400k to die miserably when you could maybe spend 396k on that and 4k putting your head in the freezer and maybe beating the whole death thing for millions of years? Instead of the whole sad funeral thing it could be a more upbeat see you in the 22nd century party.
I'm assuming how this would play out is that post singularity there would be lots of resources for brain scanning and uploading and we'd probably have a largely virtual reality existence but with the ability to use robot bodies when wanted. But who knows...
Just a word of caution, however: if things around you seem to be reverting to an earlier era, get some Ubik, quick.
http://slatestarcodex.com/2013/07/17/who-by-very-slow-decay/
One of the most impactful things I've read in my life.
While there are several contributing factors, like an activist reading of the Hippocratic Oath and fear for malpractice claims against the caregivers, this reckoning is consistent with the value system of many societies that assumes that one's informed choices must always tilt towards their continued life, and any feelings to the contrary are morally corrupt or simply misinformed, and therefore don't confer valid consent.
It's impossible to separate analyses of one's own medical death without considering wishes of one's death in the general case. Modern societies tend to make discussing death taboo, not just because it's an uncomfortable topic to grapple with, but also because people who can control the terms of their own exit have an opportunity to do great harm in ways that can't be disincentivized by punishment. It's no accident that religions attempt to rectify this loophole by ensuring that mortal deeds will determine one's fate after death.
Sometimes we can do something about it, sometimes we can't. Death can, in some cases, be quick and painless and in others slow and painful. How an individual handles this is very much up to that individual's internal being. What doesn't help is other people acting and living their lives in such a manner that brings hopelessness to the individual affected.
The medical fraternity is one group that regularly hides death from themselves and the patients and their families. Yet they will also regularly kill those who they feel have nothing left to live for and without regard to those individuals themselves.
When I was at university all those decades ago, the medical students of the time had courses in handling death - how to deal with death themselves and how to deal with patients who are dying and how to deal with families so affected.
It didn't seem to help those medical students.
My own wife has survived four different kinds of cancers. The treatments she has undergone over the years has adversely affected her body and she suffers much now from those treatments from the past. We have been blessed that we are together and that we have seen and are seeing our children grow and our grandchildren grow.
Just by living, each of us will face both good and bad. How we live each day is predicated on what gives us hope and what we see for the future. If there is no hope then death is a dark time ahead.
For me and mine, death, when it comes, will be a doorway into a better, greater future in the glorious presence of my God and Saviour. Till that time, we are here to live as examples to those around us with hope, joy and love.
https://app.printfriendly.com/print?source=homepage&url_s=uG...